Natascha McElhone: Tetanus is still killing thousands of mothers and babies in Angola
Reported, December 01, 2011
On a recent trip to Angola, actress Natascha McElhone discovered how Unicef is battling to save the lives of the most vulnerable women and children.
Not many Hollywood stars could carry off the role of assistant midwife in an isolated African village clinic with aplomb. Not many would want to. Even for mother-of-three Natascha McElhone, known for her talent in disparate roles ranging from an architect in the cult Channel 5 television show Californication to an IRA liaison officer, and even Picasso’s lover, it was quite a stretch. Because this was no theatrical set-up, but real women giving birth in extreme poverty in Matala, in southern Angola, a country that has been devastated by 30 years of civil war.
“I’d only been in the country for two days when I found myself witnessing two women being helped through labour,” says McElhone, 37, of her trip with Unicef to highlight its campaign to tackle maternal and neonatal tetanus around the world. “The midwife was focusing on one of the young women, and when I turned to look at the other I noticed her breathing had changed. I thought to myself that sounds like she’s going into transition, the period before you start to push. A few moments later, I caught the girl’s eye and she nodded towards her pelvis. I lifted up her blanket to make her more comfortable and goodness, there was a new baby there.” The baby girl was promptly named Natascha.
McElhone was visiting the maternity clinic because tetanus, a life-threatening bacterial infection is a particular problem during labour. The bacteria, which live in soil, dung and faeces, can enter the body through the umbilical cord when it is cut if a clean razor is not used, or via broken skin if the mother is not lying on a clean sheet. Once inside the body, the bacteria multiply and release a neurotoxin called tetanospasmin, which can spread through the bloodstream, blocking nerve signals from the spinal cord to the muscles. This causes muscle spasms and rigidity throughout the body, particularly in the neck, face, and jaw, hence its more traditional name of lockjaw. Death is caused by suffocation, when the respiratory muscles seize up.
There are 128,000 neonatal deaths around the world from tetanus every year; that’s one baby death every four minutes. But by vaccinating pregnant women and newborns, and offering education on hygiene in countries such as Angola, where sanitation and poverty make it a huge threat, campaigners hope to reduce the number of fatalities globally to zero.
The Angolan maternity ward was in marked contrast to the Chelsea and Westminster, the NHS flagship London hospital, where McElhone gave birth to her own sons. In Angola, women lay on metal-framed beds, where sharp springs have pierced the mattresses. Within a single room, six beds were pulled together to make the most of the space. Although there were attempts to maintain good hygiene, there was no escaping the stagnant stench.
“But it did remind me of my own labours it was almost like a sense memory,” says McElhone. ” I could identify with the waves of contractions. It’s a very unifying experience. Pregnancy and birth experiences are indelible. It made me miss my baby so much,” she says of her 12-month-old son, Rex, who was staying with his grandparents in Ireland.
McElhone had endured long labours with her three sons, Theodore, nine, Otis, six, and Rex. All were natural births. She was in labour for 36 hours with the first two, and for 24 hours with Rex. The last was an especially difficult birth, as her husband Martin Kelly, a plastic surgeon, had died from a heart attack only five months earlier in May 2008. He was 42 and it was an event that occurred completely without warning.
Despite the shock and distress, McElhone is positive and remarkably focused. She acknowledges that public interest is inevitable, but prefers her grief to be private. She points out that, like every other mother, her focus has to be on her boys. “It’s not about me, it’s about them I am the frame these days, not the picture.”
She believes that the arrival of Rex, in some ways, could not have come at a better time. It meant she was able to take an extended maternity leave, and focus her attention entirely on her family when they needed her most. For Theodore and Otis, adjusting to a little brother was a welcome diversion. “I can afford to work for three months of the year, and spend the remaining nine months being a mother. I am lucky,” she says.
“My parents are happy to help, and I set up lots of play dates for the children, a sort of whirlwind of activity while I’m working away. Martin’s male friends from the hospital still come in the evenings to see them.” When she is away, McElhone also speaks to her sons via a Skype internet phone link. She even managed to find an internet café in the middle of the Angolan countryside. “I oversee their homework and listen to piano practice, and Rex tries to lick the screen to show me how much he misses me,” she says.
In some ways, McElhone’s experience has helped her to relate to the women in Angola. “Everyone has lost someone. In the course of our trip, I don’t think we met a single woman who hadn’t witnessed the death of one of her children. I may have lost my husband, but I don’t have the same challenges that these women face every day.”
Those challenges are immense. Angola has only been at peace for three years following a civil war that began in 1975 and lasted until 2002. The country is the second largest petroleum and diamond producer in sub-Saharan Africa, but its poverty and political disruption mean that life expectancy rates are among the lowest in the world. Infant mortality rates are among the highest 158 babies (per 1,000 births) will die before the age of five; 140 mothers (per 10,000 births) will die in pregnancy, childbirth or just afterwards. Life expectancy is just 42, nearly half that of the average British woman (80.5 years). The average number of children per mother is 6.5.
Many Angolan babies and their mothers succumb to diseases such as malaria, diarrhoea and from tetanus immunity for which we take for granted in the UK. Since 1961, in Britain, babies and young children have been routinely immunised against tetanus as part of the national childhood immunisation programme. Infections are rare here, with most cases affecting those over 65 years of age who were never immunised. Between 1984 and 2004, there were 198 cases of tetanus in England and Wales. Since 1991 there has been an average of six cases each year. Moreover, there were no reported cases in children under five years of age, and, unlike Africa, there have been no cases of neonatal tetanus for more than 30 years.
McElhone was invited to Angola to see the situation at first hand by Unicef and Pampers as part of an annual “Gift of Life” campaign, with a goal to eliminate maternal and newborn tetanus by 2012. For every pack of Pampers nappies or baby wipes bought between October and Christmas 2009, the company is donating a dose of the tetanus vaccine for a mother and her baby. Since 2006, This has raised funding for 200 million tetanus vaccines, and the campaign aims to raise a further 100 million vaccines this year.
“As a mother in the UK, I’ve never had to think about the devastating effect of tetanus,” says McElhone. “I was shocked to learn that it is still killing thousands of mothers and their babies in less industrialised countries. Once newborn tetanus has been contracted, there is no real cure and, within days of exposure, it can lead to a fast and painful death.
“I have fond memories of Africa, having spent my honeymoon with Martin on safari by the Zambesi river. In fact, we enjoyed it so much that we took Theodore and Otis on a camping safari three years ago. The boys learned to play chess by candlelight, with a spear-carrying Masai warrior guarding our tent.”
Despite her fame, McElhone was barely recognised in Angola, and enjoyed the anonymity. “One woman tried to teach me how to tie a sarong so I could carry a baby on my back. I asked them ‘Doesn’t he ever fall out?’, which they found hilarious.”
Despite her grief, the actress clearly enjoyed her new role.
Credits:Victoria Lambert & more information at http://www.telegraph.co.uk/health/6515844/Natascha-McElhone-Tetanus-is-still-killing-thousands-of-mothers-and-babies.html